The World Health Organization has reported a record increase in global coronavirus cases on Sunday, with the total rising by 183,020 in a 24-hour period. The number of new daily COVID-19 cases has risen each day for the last three days, and more than 9 million people have contracted the virus around the world. It has claimed the lives of 467,000. 

Authorities in India are converting 25 luxury hotels into COVID-19 care centres as the country’s situation worsens, while in Australia there is concern that the return to work could trigger a second wave. 

Some Patients Reporting Persistent Long-term Symptoms after Recovery

Meanwhile, WHO experts also noted that some patients with COVID-19 may experience long term symptoms, including dry cough, fatigue, and shortness of breath in wake of reports that the virus may cause more persistent health issues than originally suspected. Phantom pains and motor difficulties as well as depression and psychiatric symptoms have also been reported by recovered patients a month or more after being discharged from the hospital, according to a documentary report by Israel’s N12 TV station – in a country that has reported about 21,000 cases and 306 deaths from the virus.

“We are seeing millions of people who are recovering from COVID-19, which is a very good sign. But indeed there are people who have persistence,” said WHO COVID-19 Technical Lead Maria Van Kerkhove. ” People who have more severe infection who perhaps been intubated may have some damage to their lungs and that may take a longer time to recover…We are working to better understand what recovery looks like, and more specifically, and more importantly, what type of long term care is needed.” 

WHO Calls To Ramp Up Dexamethasone Production And For Equitable Distribution 

In a parallel development, the WHO called on countries to rapidly ramp up dexamethasone production, a widely-available steroid drug with “life-saving potential”, and to ensure that no country bearing a heavy COVID-19 toll is left behind.

“The next challenge is to increase production and rapidly and equitably distribute dexamethasone worldwide, focusing on where it is needed most”, said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

Dexamethasone is the first known drug to slash mortality in critically ill COVID-19 patients, according to last week’s preliminary results from the UK-wide Recovery trial. Dexamethasone reduced mortality by a third in patients on mechanical ventilation, and by one fifth in patients on oxygen.

“Guided by solidarity, countries must work together to ensure supplies are prioritized for countries where there are large numbers of critically ill patients, and that supplies remain available to treat other diseases for which it is needed.”

The WHO is confident that dexamethasone production can be accelerated because it’s inexpensive, widely available, with multiple drug manufacturers worldwide.

But it will be essential to monitor the drug’s quality as its mass produced, he warned, as there is a “high risk of substandard or falsified products entering the market.”

And patients that require dexamethasone for other conditions like arthritis, asthma or lupus, must not be forgotten either, he added.

Although dexamethasone curbs mortality in patients with severe or critical COVID-19 disease, there is still ‘no evidence’ that it works in patients with mild disease or as a prophylactic against the coronavirus, warned the WHO.

Coronavirus Cases Rebound In Countries That Suppressed the Virus

“We urge countries to be careful and creative in finding solutions that allow people to stay safe while getting on with their lives,” said Dr Tedros. “Finding and testing suspected cases, isolating and caring for the sick, tracing and quarantining contacts, and protecting health workers works at the same time. 

“But these measures can only be effective if each and every individual takes the measures that we also know work to protect themselves and others. Maintain physical distance. Continue cleaning your hands and wear a mask where appropriate,” the WHO Director-General added. 

Republic of Korea and China also Reporting Rise in New Cases

Some countries that have largely suppressed the virus, such as the Republic of Korea and China, have seen a rise in new cases.

“There are many countries right now which have had success in suppressing transmission down to a low level that are starting to see an increase in cases,” said WHO Health Emergencies Executive Director Mike Ryan. “It’s really important to… isolate cases so that the outbreaks don’t become larger, and that these small numbers of cases don’t become clusters and that these clusters of cases don’t become community transmission again.”

For example, the Republic of Korea has reported new clusters of COVID-19 in “multiple settings” in the capital city of Seoul, said Ryan. However, “vast majority” of new cases have been linked to recognized clusters of disease and thus the Korean authorities “still have great visibility over where [the virus] is.” 

A number of outbreaks have also occurred in food processing plants across many countries, including in a German meatpacking factory. On a larger scale, several United States states such as Texas, Arizona, Florida, and North Carolina have seen sharp upticks in cases following reopenings.

“What is clear is that the increase is not entirely explained through just increased testing. There’s some evidence of increasing hospitalizations, but this was always a possibility when restrictions are lifted,” said Ryan, of the increased case numbers in the US. “The issue is not the rising numbers per se. The issue is what has to be done to bring those numbers back down, and what combination of public health measures can be used in order to do this.”

Image Credits: Busan Metropolitan City.